Saturday, December 30, 2006

If you did the workouts from the last post, you faced childhood angst head on and rewrote history by blowing the doors off of the Presidential Fitness Test (the Govenator would be proud). If you still have issues, you can always exorcise (or exercise) a few demons by joining PRO'sdodgeball league.

With that little bit of psychological housekeeping done for the New Year, let's face the 'This isn't what I wanted to be when I grew up' crisis that's often labeled 'How did I get here?!' Did you dream about being a Police Officer, a Firefighter, a Soldier? Let's at least start 2007 with the knowledge that you could still make that happen by passing the physical requirements.

What if it's all been a big fat lie? was the provocative question Gary Taubes asked in his award winning article that questioned the basis of established guidelines for dietary fat consumption. He may now be in hiding alongside Salman Rushdie with a similar fatwa issued instead by the USDA. Between his work and that of the Weston A. Price Foundation, I urge you to challenge what you think you know about dietary fat.

After an introduction in which Taubes entertains the idea that the often maligned Dr. Atkins may actually be correct in his theories, Taubes continues by saying, "Now a small but growing minority of establishment researchers have come to take seriously what the low-carb-diet doctors have been saying all along. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health, may be the most visible proponent of testing this heretic hypothesis [lower carbohydrate consumption]. Willett is the de facto spokesman of the longest-running, most comprehensive diet and health studies ever performed, which have already cost upward of $100 million and include data on nearly 300,000 individuals. Those data, says Willett, clearly contradict the low-fat-is-good-health message ''and the idea that all fat is bad for you; the exclusive focus on adverse effects of fat may have contributed to the obesity epidemic.''"These researchers point out that there are plenty of reasons to suggest that the low-fat-is-good-health hypothesis has now effectively failed the test of time. In particular, that we are in the midst of an obesity epidemic that started around the early 1980's, and that this was coincident with the rise of the low-fat dogma. (Type 2 diabetes, the most common form of the disease, also rose significantly through this period.) They say that low-fat weight-loss diets have proved in clinical trials and real life to be dismal failures, and that on top of it all, the percentage of fat in the American diet has been decreasing for two decades. Our cholesterol levels have been declining, and we have been smoking less, and yet the incidence of heart disease has not declined as would be expected. ''That is very disconcerting,'' Willett says. ''It suggests that something else bad is happening.''

"Scientists are still arguing about fat, despite a century of research, because the regulation of appetite and weight in the human body happens to be almost inconceivably complex, and the experimental tools we have to study it are still remarkably inadequate. This combination leaves researchers in an awkward position. To study the entire physiological system involves feeding real food to real human subjects for months or years on end, which is prohibitively expensive, ethically questionable (if you're trying to measure the effects of foods that might cause heart disease) and virtually impossible to do in any kind of rigorously controlled scientific manner. But if researchers seek to study something less costly and more controllable, they end up studying experimental situations so oversimplified that their results may have nothing to do with reality. This then leads to a research literature so vast that it's possible to find at least some published research to support virtually any theory. The result is a balkanized community -- ''splintered, very opinionated and in many instances, intransigent,'' says Kurt Isselbacher, a former chairman of the Food and Nutrition Board of the National Academy of Science -- in which researchers seem easily convinced that their preconceived notions are correct and thoroughly uninterested in testing any other hypotheses but their own."

"What's more, the number of misconceptions propagated about the most basic research can be staggering. Researchers will be suitably scientific describing the limitations of their own experiments, and then will cite something as gospel truth because they read it in a magazine. The classic example is the statement heard repeatedly that 95 percent of all dieters never lose weight, and 95 percent of those who do will not keep it off. This will be correctly attributed to the University of Pennsylvania psychiatrist Albert Stunkard, but it will go unmentioned that this statement is based on 100 patients who passed through Stunkard's obesity clinic during the Eisenhower administration.""

Mary Enig, PhD, and Sally Fallon outline their argument for the benefits of saturated fats in 'the Skinny on Fats' which explains the necessary functions of various fats and cholesterol and their importance. Some of that article appears below though I would urge you to read the entire text:The Benefits of Saturated Fats

The much-maligned saturated fats—which Americans are trying to avoid—are not the cause of our modern diseases. In fact, they play many important roles in the body chemistry:

Saturated fatty acids constitute at least 50% of the cell membranes. They are what gives our cells necessary stiffness and integrity.

They play a vital role in the health of our bones. For calcium to be effectively incorporated into the skeletal structure, at least 50% of the dietary fats should be saturated.38

They lower Lp(a), a substance in the blood that indicates proneness to heart disease.39

They protect the liver from alcohol and other toxins, such as Tylenol.40

They are needed for the proper utilization of essential fatty acids. Elongated omega-3 fatty acids are better retained in the tissues when the diet is rich in saturated fats. 42

Saturated 18-carbon stearic acid and 16-carbon palmitic acid are the preferred foods for the heart, which is why the fat around the heart muscle is highly saturated.43 The heart draws on this reserve of fat in times of stress.

Short- and medium-chain saturated fatty acids have important antimicrobial properties. They protect us against harmful microorganisms in the digestive tract.

The scientific evidence, honestly evaluated, does not support the assertion that "artery-clogging" saturated fats cause heart disease.44 Actually, evaluation of the fat in artery clogs reveals that only about 26% is saturated. The rest is unsaturated, of which more than half is polyunsaturated.45

What about Cholesterol?

And what about cholesterol? Here, too, the public has been misinformed. Our blood vessels can become damaged in a number of ways—through irritations caused by free radicals or viruses, or because they are structurally weak—and when this happens, the body's natural healing substance steps in to repair the damage. That substance is cholesterol. Cholesterol is a high-molecular-weight alcohol that is manufactured in the liver and in most human cells. Like saturated fats, the cholesterol we make and consume plays many vital roles:

Along with saturated fats, cholesterol in the cell membrane gives our cells necessary stiffness and stability. When the diet contains an excess of polyunsaturated fatty acids, these replace saturated fatty acids in the cell membrane, so that the cell walls actually become flabby. When this happens, cholesterol from the blood is "driven" into the tissues to give them structural integrity. This is why serum cholesterol levels may go down temporarily when we replace saturated fats with polyunsaturated oils in the diet.46

Cholesterol acts as a precursor to vital corticosteroids, hormones that help us deal with stress and protect the body against heart disease and cancer; and to the sex hormones like androgen, testosterone, estrogen and progesterone.

Cholesterol is a precursor to vitamin D, a very important fat-soluble vitamin needed for healthy bones and nervous system, proper growth, mineral metabolism, muscle tone, insulin production, reproduction and immune system function.

The bile salts are made from cholesterol. Bile is vital for digestion and assimilation of fats in the diet.

Recent research shows that cholesterol acts as an antioxidant.47 This is the likely explanation for the fact that cholesterol levels go up with age. As an antioxidant, cholesterol protects us against free radical damage that leads to heart disease and cancer.

Cholesterol is needed for proper function of serotonin receptors in the brain.48 Serotonin is the body's natural "feel-good" chemical. Low cholesterol levels have been linked to aggressive and violent behavior, depression and suicidal tendencies.

Mother's milk is especially rich in cholesterol and contains a special enzyme that helps the baby utilize this nutrient. Babies and children need cholesterol-rich foods throughout their growing years to ensure proper development of the brain and nervous system.

Dietary cholesterol plays an important role in maintaining the health of the intestinal wall.49 This is why low-cholesterol vegetarian diets can lead to leaky gut syndrome and other intestinal disorders.

Cholesterol is not the cause of heart disease but rather a potent antioxidant weapon against free radicals in the blood, and a repair substance that helps heal arterial damage (although the arterial plaques themselves contain very little cholesterol.) However, like fats, cholesterol may be damaged by exposure to heat and oxygen. This damaged or oxidized cholesterol seems to promote both injury to the arterial cells as well as a pathological buildup of plaque in the arteries.50 Damaged cholesterol is found in powdered eggs, in powdered milk (added to reduced-fat milks to give them body) and in meats and fats that have been heated to high temperatures in frying and other high-temperature processes.

High serum cholesterol levels often indicate that the body needs cholesterol to protect itself from high levels of altered, free-radical-containing fats. Just as a large police force is needed in a locality where crime occurs frequently, so cholesterol is needed in a poorly nourished body to protect the individual from a tendency to heart disease and cancer. Blaming coronary heart disease on cholesterol is like blaming the police for murder and theft in a high crime area.

Poor thyroid function (hypothyroidism) will often result in high cholesterol levels. When thyroid function is poor, usually due to a diet high in sugar and low in usable iodine, fat-soluble vitamins and other nutrients, the body floods the blood with cholesterol as an adaptive and protective mechanism, providing a superabundance of materials needed to heal tissues and produce protective steroids. Hypothyroid individuals are particularly susceptible to infections, heart disease and cancer.51

Classification of Fatty Acids by Saturation

Fatty acids are classified in the following way:

Saturated: A fatty acid is saturated when all available carbon bonds are occupied by a hydrogen atom. They are highly stable, because all the carbon-atom linkages are filled—or saturated—with hydrogen. This means that they do not normally go rancid, even when heated for cooking purposes. They are straight in form and hence pack together easily, so that they form a solid or semisolid fat at room temperature. Your body makes saturated fatty acids from carbohydrates and they are found in animal fats and tropical oils.

Monounsaturated: Monounsaturated fatty acids have one double bond in the form of two carbon atoms double-bonded to each other and, therefore, lack two hydrogen atoms. Your body makes monounsaturated fatty acids from saturated fatty acids and uses them in a number of ways. Monounsaturated fats have a kink or bend at the position of the double bond so that they do not pack together as easily as saturated fats and, therefore, tend to be liquid at room temperature. Like saturated fats, they are relatively stable. They do not go rancid easily and hence can be used in cooking. The monounsaturated fatty acid most commonly found in our food is oleic acid, the main component of olive oil as well as the oils from almonds, pecans, cashews, peanuts and avocados.

Polyunsaturated: Polyunsaturated fatty acids have two or more pairs of double bonds and, therefore, lack four or more hydrogen atoms. The two polyunsaturated fatty acids found most frequently in our foods are double unsaturated linoleic acid, with two double bonds—also called omega-6; and triple unsaturated linolenic acid, with three double bonds—also called omega-3. (The omega number indicates the position of the first double bond.) Your body cannot make these fatty acids and hence they are called "essential." We must obtain our essential fatty acids or EFA's from the foods we eat. The polyunsaturated fatty acids have kinks or turns at the position of the double bond and hence do not pack together easily. They are liquid, even when refrigerated. The unpaired electrons at the double bonds makes these oils highly reactive. They go rancid easily, particularly omega-3 linolenic acid, and must be treated with care. Polyunsaturated oils should never be heated or used in cooking. In nature, the polyunsaturated fatty acids are usually found in the cis form, which means that both hydrogen atoms at the double bond are on the same side.

All fats and oils, whether of vegetable or animal origin, are some combination of saturated fatty acids, monounsaturated fatty acids and polyunsaturated linoleic acid and linolenic acid. In general, animal fats such as butter, lard and tallow contain about 40-60% saturated fat and are solid at room temperature. Vegetable oils from northern climates contain a preponderance of polyunsaturated fatty acids and are liquid at room temperature. But vegetable oils from the tropics are highly saturated. Coconut oil, for example, is 92% saturated. These fats are liquid in the tropics but hard as butter in northern climes. Vegetable oils are more saturated in hot climates because the increased saturation helps maintain stiffness in plant leaves. Olive oil with its preponderance of oleic acid is the product of a temperate climate. It is liquid at warm temperatures but hardens when refrigerated.

Classification of Fatty Acids by Length

Researchers classify fatty acids not only according to their degree of saturation but also by their length.

Short-chain fatty acids have four to six carbon atoms. These fats are always saturated. Four-carbon butyric acid is found mostly in butterfat from cows, and six-carbon capric acid is found mostly in butterfat from goats. These fatty acids have antimicrobial properties—that is, they protect us from viruses, yeasts and pathogenic bacteria in the gut. They do not need to be acted on by the bile salts but are directly absorbed for quick energy. For this reason, they are less likely to cause weight gain than olive oil or commercial vegetable oils.27 Short-chain fatty acids also contribute to the health of the immune system.28

Medium-chain fatty acids have eight to twelve carbon atoms and are found mostly in butterfat and the tropical oils. Like the short-chain fatty acids, these fats have antimicrobial properties; are absorbed directly for quick energy; and contribute to the health of the immune system.

Long-chain fatty acids have from 14 to 18 carbon atoms and can be either saturated, monounsaturated or polyunsaturated. Stearic acid is an 18-carbon saturated fatty acid found chiefly in beef and mutton tallows. Oleic acid is an 18-carbon monounsaturated fat which is the chief component of olive oil. Another monounsaturated fatty acid is the 16-carbon palmitoleic acid which has strong antimicrobial properties. It is found almost exclusively in animal fats. The two essential fatty acids are also long chain, each 18 carbons in length. Another important long-chain fatty acid is gamma-linolenic acid (GLA) which has 18 carbons and three double bonds. It is found in evening primrose, borage and black currant oils. Your body makes GLA out of omega-6 linoleic acid and uses it in the production of substances called prostaglandins, localized tissue hormones that regulate many processes at the cellular level.

Very-long-chain fatty acids have 20 to 24 carbon atoms. They tend to be highly unsaturated, with four, five or six double bonds. Some people can make these fatty acids from EFA's, but others, particularly those whose ancestors ate a lot of fish, lack enzymes to produce them. These "obligate carnivores" must obtain them from animal foods such as organ meats, egg yolks, butter and fish oils. The most important very-long-chain fatty acids are dihomo-gamma-linolenic acid (DGLA) with 20 carbons and three double bonds; arachidonic acid (AA) with 20 carbons and four double bonds; eicosapentaenoic acid (EPA) with 20 carbons and five double bonds; and docosahexaenoic acid (DHA) with 22 carbons and six double bonds. All of these except DHA are used in the production of prostaglandins, localized tissue hormones that direct many processes in the cells. In addition, AA and DHA play important roles in the function of the nervous system.29

Wednesday, December 27, 2006

I'm Sicilian and if I'm not talking with my hands I'm not talking. And, well, I'm talking a lot. I'm also tapping a foot, shifting from side to side, rocking in my chair and any combination of all of those things. It would be maddening and maybe even stigmatizing if it didn't turn out to be darn useful.

Fidgeting is not something I developed for it's healthful benefits. The truth is, I'm not sure why I do it though I wonder sometimes if it's genetic. An observer commented recently that whatever internal beat my sister and I were dancing to, it was at least nicely synchronized. We had no idea what he was talking about as we stood side by side silently swaying.

When the topic of fidgeting came up recently in a trainer meeting, I swear a few people glanced at me. It seems the Mayo Clinic did some research on Non-Exercise Activity Thermogenesis (NEAT) which is essentially an individuals energy expenditure (EE) during activity that does not constitute 'exercise'.

As the Mayo clinic explains, EE has three components:

Basal Metabolic Rate: "BMR is the energy expended when an individual is laying at complete rest, in the morning, after sleep, in the postabsorptive state. In individuals with sedentary occupations BMR accounts for approximately 60 percent of total daily EE. Three-quarter's of the variability in BMR is predicted by lean body mass within and across species." Though some argue that lean body mass alters caloric expenditure by only a handful of calories, I suspect that's not the whole story if you consider the process of building mass as well as the elevated caloric expenditure post-exercise. For an anaerobic workout (weight-lifting) energy expenditure stays elevated for 72 hours after the workout ends.

Thermic Effect of Food: "TEF is the increase in EE associated with the digestion, absorption, and storage of food and accounts for approximately 10-15 percent of total daily EE." The intake of nutrients is known to increase energy expenditure." Measured thermic effects of nutrient are 0-3% for fat, 5-10% for carbohydrates and 20-30% for proteins. And, by the way, you'll notice this is another argument for a higher protein diet.

Activity Thermogenesis: "Activity Thermogenesis has two constituents, exercise-related activity thermogenesis and Non-exercise Activity Thermogenesis (NEAT). For the vast majority of dwellers in the U.S., exercise activity thermogenesis is negligible. NEAT, even in avid exercisers, is the predominant constituent of activity thermogenesis and is the EE associated with all the activities we undertake as vibrant, independent beings. NEAT has an enormous variety of constituents including occupation, leisure and fidgeting."

Given the holidays and what was likely a change in patterns that included more food and less time in the gym, the following point is particularly relevant: "With experimental overfeeding in humans, NEAT increases. Those who increased their NEAT the most with overfeeding gained the least fat. This suggests that along with self-evident societal slothfulness, NEAT is biologically modulated. Animal data support this." What this means is that folks who bemoan a slow metabolism may be able to keep foods from 'sticking' quite so readily (click your heels, Dorothy . . . .)

According to the Mayo Clinic's research, "Even lean individuals store at least two to three months of their energy needs in adipose tissue whereas obese persons can carry a year's worth of their energy needs." Yes, they said a year. You may want to begin chipping away at that surplus by vigorously flapping your arms but I suspect that your friends won't find that either charmingly quirky or endearing. Instead, PRO endeavored to experiment using pedometers for the 20/20 clients with a requirement that they walk at least 5000 steps a day. Walking is categorized as NEAT and would represent some of the unintentional EE in question.

I too donned a pedometer and only in part because it was free. I was curious after reading several years ago that the average American walks 1000 steps a day while the average European walks approximately 10000 steps a day. And though I was trying to capture my average, bless my viciously competitive heart, I kept driving up the numbers.

I walked downtown from my Capitol Hill home several times to browse for Christmas gifts that I had no intention of buying. I made highly inefficient trips to the grocery store, walking the three blocks multiple times on a Sunday for individual items (though I've been known to call that QFC 'my other fridge', that was getting silly). I parked farther away from store entrances which I have often told clients to do but never intentionally done myself. And while shopping for the holiday brunch I cooked, I parked my cart in the middle of the store, retrieved each item one by one and returned to the cart to deposit them boosting my numbers significantly.

Given that I sometimes exercise multiple times a day, this would seem completely extraneous. When you ask yourself what does being healthy mean and what does it say about your lifestyle however, I would think part of the answer would be energy and vitality. It would also imply that your exercise fuels an active life rather than depletes you and keeps you circling parking lots in a holding pattern for 'rock star' parking. Having only two speeds, 'Stop' and 'Go', doesn't scream 'vibrant' to me.

Saturday, December 23, 2006

For those of us who weren't attached to the knee in question, it was the ungodly noise of an epic mechanical failure that made us all wince. Our friend Harlan was wincing for entirely different reasons. Mid-'Helen' with only three pull-ups to go and it was the small hop to the pull-up bar that ripped muscle from bone. And yet it wasn't really. The groundwork for this particular injury was built on the road - long slow distances on bike and foot that led to bouts of inflammation in the form of tendinitis and the resultant scar tissue that made his tendons ripe for this kind of injury.

As Coach Rippetoe pointed out when coaching a snatch, it's not instinctual to step under falling weight. The risks are obvious and don't require any explanation. In long slow distance (LSD) events, however, athletes are not only pursued by the competitor behind them but by repeat-motion injuries and cumulative stress that dog their every step. It's just not as obvious a threat as falling weight.

In the LSD culture, 'run through it' is not only the common approach to most injuries it's a 'merit badge' of sorts. It's so ingrained that LSD athletes stop questioning the 'why' of injury and consider it almost as necessary to their training as top of the line running shoes. The exploration of their diagnosis generally stops after the question, "But can I keep running/biking?" is answered.

In tendinitis of the knee, there are four stages:

Stage 1 - Pain only after activity, without functional impairment
Stage 2 - Pain during and after activity, although the patient is still able to perform satisfactorily in his or her sport
Stage 3 - Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory level
Stage 4 - Complete tendon tear requiring surgical repair

You'll note that the question of 'can I keep running/biking?' is technically 'yes' until stage 4. The fact that the activity can be performed, with 'increased difficulty' of course, up until surgical repair seems to be enough to speed people along through the gruesome completion of all four steps. After stage 4, the answer of 'can I keep running/biking?' is decidedly 'no'.

Tendinitis: Everything is just swell

From http://www.tendinitis.net/ "A tendon is the end part of a muscle that attaches the muscle to the bone. The normally very elastic and soft muscle tapers off at the end to form the much more dense and stiff tendon. While this density makes the tendons stronger, the lack of elasticity of the tendon and the constant pulling on its attachment to the bone with movement, makes it much more susceptible to a low level of tearing at a microscopic level. This tearing will produce the inflammation and irritation known as tendinitis."

"With proper care for the area, the pain in the tendon should lessen over three weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least six weeks following the initial injury. This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue will continue to form past six weeks in some cases and as long as a year in severe cases. After 6 months this condition is considered chronic and much more difficult to treat."

"After the scar tissue has begun to accumulate, it will be important to perform procedures which help break down the scar tissue in the tendon tissue, so as to let the tendon and muscle regain it's normal flexibility and lessen the chance of further injury. While exercise is appropriate for breaking down scar tissue once the area has healed, it may further irritate the area during the initial stages."

Tendinitis, is common to the LSD athlete and can plague a mixed-modal athlete (read CrossFitter) as well. The difference is that a LSD athlete has few tools to rely on and when impaired, loses forward momentum in their sport. A mixed modal athlete can rest afflicted areas and continue to improve adding valuable skills while recuperating.

Fighting inflammation or not?

In my research, conflicting reports existed as to whether or not inflammation is a factor. I read many entries in PubMed that discussed the absence of inflammation but those abstracts weren't as easy to digest and threatened to send you skittering off subject and back to you e-mail queue. I offer the following link to active.com which sums up the issue nicely but may not be the most reliable resource.

"For decades, overuse injuries have been treated with anti-inflammatory methods. These include non-steroidal anti-inflammatory drugs (NSAIDs such as Advil and Motrin), electric stimulation, steroid injections and ice therapy. However, research, including a 2000 study in The Physician and Sportsmedicine and a 2003 study in Clinics in Sports Medicine, indicates that most overuse conditions are not inflammatory in nature and that treating them as such may delay or prevent full recovery.

If inflammation isn't responsible for chronic conditions like tennis elbow and iliotibial band syndrome, what is? There's a good chance it's scar tissue. Repeated or sustained muscular contractions in any athletic endeavor increases tension on soft tissues (muscles, tendons, fascia and nerves), which in turn decreases blood and oxygen supply to the area.
With muscles, nerves and fascia, the result is a build-up of scar tissue. In tendons, decreased oxygen leads to degeneration. Scar tissue and degeneration are the common cause of chronic overuse injuries, whereas inflammation is predominant in acute injuries such as muscle and ligament tears.

Although the understanding of overuse injuries has improved with continued research, most traditional medical paradigms have not yet adapted, partially explaining why some injuries seem resistant to treatment. Karim M. Khan, M.D., Ph.D., a primary researcher on overuse injury, affirms, "Treatment needs to combat (scar tissue) breakdown rather than inflammation."

It's my assertion that inflammation is present at the onset of the injury and flares up when the injury is aggravated but that the long term chronic nature of the problem is due to the scar tissue as stated above. Therefore, it's prudent to treat flare-ups with anti-inflammatory protocols as it will limit additional scar tissue formation.

Couch-Surfing: Neither a sport nor an option

If your tendons are at risk, why stress them in the first place? Glad you asked. The question is, how do you gain the benefits, listed below without the cumulative stress of LSD? Simply reduce the duration, and vary the loads (read CrossFit). I'll spare you the link partly because you'll only find the abstract and because the complete article is not in English.

Connective tissue of the human tendon plays an important role in force transmission. The extracellular matrix turnover of tendon is influenced by physical activity. Blood flow, oxygen demand, and the level of collagen synthesis and matrix metalloproteinases increase with mechanical loading. Gene transcription and especially post-translational modifications of proteins of the extracellular matrix are enhanced following exercise. Conversely, inactivity markedly decreases collagen turnover. Training leads to a chronically increased collagen turnover, and dependent on the type of collagen also to some degree of net collagen synthesis. These changes modify the biomechanical properties of the tissue (for example, viscoelastic characteristics) as well as the structural properties of the in collagen (for example, cross-sectional area). Mechanical loading of human tendon does result in a marked interstitial increase in growth factors that are known potentially to stimulate synthesis of collagen and other extracellular matrix proteins. Taken together, human tendon tissue mounts a vigorous acute and chronic response to mechanical loading in terms of metabolic-circulatory changes as well as of extracellular matrix formation. These changes may contribute to training-induced adaptation of biomechanical properties consisting of altered resistance to loading and enhanced tolerance to strenuous exercise. Understanding of such changes is a pre-requisite in the development of measures aimed at prevention of overuse tendon injuries occurring during sport, work or leisure-related activities. PMID: 15788870 [PubMed - indexed for MEDLINE]

Squat = good: Just had to throw this in

The Allan McGavin Sports Medicine Centre and School of Human Kinetics
University of British Columbia, Vancouver, Canada.

OBJECTIVES: To compare the therapeutic effect of two different exercise protocols in athletes with jumper's knee (this is the tendinitis in question which is referred to by this common term)

METHODS: Randomised clinical trial comparing a 12 week programme of either drop squat exercises or leg extension/leg curl exercises. Measurement was performed at baseline and after six and 12 weeks. Primary outcome measures were pain (visual analogue scale 1-10) and return to sport. Secondary outcome measures included quadriceps and hamstring moment of force using a Cybex II isokineticdynamometer at 30 degrees/second. Differences in pain response between the drop squat and leg extension/curl treatment groups were assessed by 2 (group) x 3 (time) analysis of variance. Two by two contingency tables were used to test differences in rates of return to sport. Analysis of variance (2 (injured versus non-injured leg) x 2 (group) x 3 (time)) was also used to determine differences for secondary outcome measures.

RESULTS: Over the 12 week intervention, pain diminished by 2.3 points (36%) in the leg extension/curl group and 3.2 points (57%) in the squat group. There was a significant main effect of both exercise protocols on pain (p<0.01) size="4">The Challenge
'Quad Sets' or, in other words, leg lifts are the standard protocol for the first stage of therapy for a knee injury because it allows the quadriceps to fire due to hip flexion without further aggravation at the joint. The CrossFit version of that is the classic L-sit which again features hip flexion as the focus. With a stop watch, accumulate 2 minutes of hold in the L-Sit or with the assistance a band, do 100 2-second holds.

Friday, December 22, 2006

I sent the following workouts to one of my traveling 'Firebreathers' (to use a popular CFE term). For folks familiar with these exercises, feel free to try a couple of these workouts and let me know how it goes. We're still not at full power at PRO, but I'm putting together an article on inflammation which I'll post in the next couple of days.W/O1Row 500m25 Manmakers @25#3 Rounds

W/O215 Pull-ups15 of three front squats with one Thruster @85#40 Swings @35#3 Rounds

Wednesday, December 20, 2006

Because of the storm last week, PRO Club is still not operating at full capacity. Until we have full power, I won't be able to post. We currently have eighty trainers in a very small room wrestling for control over four computers. Though I may have an unfair advantage, I certainly don't have the ability to think clearly with all the chaos.

Thursday, December 14, 2006

Macronutrients - I love that we're still arguing about them! Truly it gives us more room to tinker with so-called absolutes when we realize that nutritional guidelines are sometimes as accurate as our daily horoscope. Keep in mind that 'qualified professionals' are developing both.

As if nutritional science isn't already an intricate weave of twisted statistics we have no choice but to factor in the influence of food lobbyists when guidelines are finally agreed upon. The book by Marion Nestle 'Food Politics: How the Food Industry Influences Nutrition and Health (California Studies in Food and Culture, 3)' will unsettle you when you realize how little our health factors into decisions regarding food labeling. That said, it didn't surprise me that protein intakes were not only still up for debate, they're the topic of a science smack-down by two very formidable foes.

Loren Cordain, Ph.D., Department of Health and Exercise Science Professor at Colorado State University and T. Colin Campbell, Ph.D., a Jacob Gould Shurman Professor Emeritus of Nutritional Biochemistry at Cornell University present hugely contrasting viewpoints in a dueling debate presented by Performance Menu. I was excited by the opportunity to read dovetailed arguments, as both scientists provide a rebuttal, and make a decision for myself. I wanted to be unbiased and I tried to leave my own opinions and experience out of the reading but, alas, Campbell made that next to impossible.

Campbell, co-author of 'The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health' seems to be a big fan of backward engineering in which he takes some of the healthiest people he can find and asks them what they eat. This would be great if we weren't bothered by factor such as variances in food quality, food sources, genetics, environments, stressors, etc. I suspect the book covers these issues far better than his essay 'How much protein is needed?' which seems happy to stick to the parental justification "because I said so!" as his most compelling argument. Like the child on the other end of that statement, I wanted to cross my arms and stamp my foot in frustration.

Cordain, author of 'The Paleo Diet' and 'The Paleo Diet for Athletes' on the other hand has three pages of references to back up his conclusion that "The evolutionary evidence indicates that so called "high protein diets" (20-30% total energy) and "very high protein diets" (30-40% of total energy) actually represent the norm which conditioned the present day human genome over more than 2 million years of evolutionary experience". The references made me cozy up to his argument even if I hadn't already done so. He made a compelling case that evolution isn't an overnight phenomenon and we need to look at our past, as it predates many modern ailments, in order to understand our dietary design.

Campbell's manifesto suggests many-times over in a writing style not too dissimilar from the Unabomber that protein intake from plant sources should only be 10% of total calories and it's primary purpose is the replacement of nitrogen. Footloose and footnote free, he'll assert his recommendation over and over again in case you were too slow to catch it. Did I mention it was 10%? He seems to find it laughable that anyone would study evolution for clues to nutrition and his assessment of Cordain's work borders on a personal attack. His desire to study only present day nutrition, however, makes me wonder how strong a role luncheon meat could play in spoiling his outcomes (never mind his sandwich). I think I could get cancer looking at Bologna so I doubt I'd trust any data that counts its composition as a protein source. I'm not sure if that's the case in his research but I bet I'd know if I had access to his references.

Robb Wolf alluded to further comments from Campbell. Until and unless that's forthcoming, the debate will be the last word on protein. Well, until someone else has a last word.

Note: Folks on p-menu's message board clamored for science heavyweights to brawl over fats next. Having read most of Weston A. Price's information about saturated fats, it would be a juicy read. It's clear saturated fat has gotten a bad wrap. Between the data and the creepy font, I was so skeptical I fact-checked all of Price's footnotes because I thought I'd find fictional sources but everything was solid at room temperature. I guarantee you'll go to the food isle, personally apologize to the butter and demand the government do so officially. For the government end, you might want to hire a lobbyist.

Wednesday, December 13, 2006

Can we please call a New Year's Resolution something else so that we can stop mocking the idea and hunker down for a little self improvement? I believe we trainers call it goal-setting and I have a loftier one for all of us this year. Passion.

I'm Sicilian and I'm a passionate person. My mother's the same way and when I was growing up her intensity made me think she was angry all the time. The woman has a rather expressive eyebrow that when raised inspires a very rapid adrenal response from me. She also has a fierce reaction to even a whiff of threat to her children's well-being. Don't get me wrong, at 5'6" (and shrinking - sorry, mom), and only a bit less of the warrior queen I remember, she still scares the bajeebers out of me but now I find it endearing.

I channel my own passion into the things that I do. Don't mistake that for the idea that I do everything well. I started Muay Thai again recently and frankly I'm terrible at it. That's not a low-self-esteem assessment that's just what's so. But if I approach this with passion and don't get self-conscious about my poor performance, I'll excel with time. Imagine how little I'd accomplish if I only did the things I'm good at.

I'm not sure if I was bad at Brazilian JiuJitsu. Who remembers five years ago? Uncoordinated, probably, but persistent and passionate. Now I have experience to share because I stuck with it and I've reached a level of expertise that's respected. I know that's not what I saw happening years ago. What I saw is one lost girl getting knocked about by a bunch of SWAT officers and trying not to be seriously injured. It wasn't pretty but I knew time, commitment and passion would make the difference.

My mom's example - obstacles are meant to be knocked down, out-strategized or just plain intimidated - was an important one. It's not that she beat everything - she's still a diabetic with the complications that go with that. She goes down swinging, though and I'll never make the mistake of telling her she can't do anything or underestimating what she's capable of.

Be courageous and declare out loud what you intend to do with passion. What will consume you, drive you, and occupy those spaces in your mind when your thoughts drift? Decide now, lay the groundwork, make a real commitment to it and be prepared for a change in how you approach everything in your life once you develop a passion for something. Oh, and do all that by January 1st.

The ChallengeThose of you who have been around CrossFit for awhile know how 'Fran' can make your stomach lurch and your eyes search for an exit. Until you get used to dealing with fear and discomfort as nothing more than fear and discomfort, you dread starting this workout. I dread it and I managed to finish it in 4:01 which seems like a lot of anxiety for less than five minutes of work. My challenge to you is to face 'Fran': Tear it up, make loud noises, draw blood, fall to the floor with chest heaving and give your best stink-eye to anyone who has the audacity to stare in horror.

Fran21.15.9Thrusters (95# for men, 65# for women)Pull-ups

Modify as necessary.

Note: This is a CrossFit workout. You can find the rest of the 'Girls' - benchmark workouts named after hurricanes - in CrossFit'sFAQ.

Tuesday, December 12, 2006

My last post didn't include any workouts. This wasn't some sort of strategy, I was late for a meeting regarding 'Transference in Client/Trainer Relationships'. Which, in a nutshell, means please don't get me anything for Christmas. It also means that these workouts are a bit recycled. I'm trying to send you everything that can be done without weights and in small spaces since many of you will be spending time away from the gym in the next month:

It's funny that Senators John McCain and John Warner continue to argue in the Military Commissions Act of 2006 that sleep deprivation is torture and the CIA continues to use it as an 'enhanced interrogation technique,' yet we, the common populace, brag over our 6-Shot latte about our meager four hours of sleep the night before.

As one of those hearty never-say-die New Englanders, I have in the past taken pride in the fact that I 'require' very little sleep. And just to prove sleep deprivation impairs judgment, I was staying up to watch Sex in the City on UPN at 11:00p. There are several things wrong with this; 1. I can rent it, 2. it's edited for TV anyway, 3. I've seen all the episodes at least twice, 4. watching it makes me feel all jaded and stuff.

And I know my clients do it too - maybe not the 'Sex in the City' part, but workloads often demand longer hours. In a Harvard Business Online interview with Dr. Charles Czeisler, Professor of Sleep Medicine at Harvard Medical School, long-houred executives are described accordingly, "People like this put themselves, their teams, their companies, and the general public in serious jeopardy." The interviewer in this piece, Bronwyn Fryer, states, "To him, encouraging a culture of sleepless machismo is worse than nonsensical; it is downright dangerous, and the antithesis of intelligent management. He notes that while corporations have all kinds of policies designed to prevent employee endangerment—rules against workplace smoking, drinking, drugs, sexual harassment, and so on—they sometimes push employees to the brink of self-destruction. Being “on” pretty much around the clock induces a level of impairment every bit as risky as intoxication."

This from the same physician whose research showed that the risk of mistakes by attendings during weeks that include round the clock (30 hours) shifts increased by 700%. Um, that's statistically significant. The risk of death from these mistakes is three times higher. Interesting that when you're lack of sleep lands you in the hospital with your very own infarction, it will be the butter-fingered, sleep restricted resident that's responsible for fixing you.

Though your own bad habits are unlikely to lead to an untimely death - providing you take public transportation and don't operate industrial equipment - the impact on your day to day life is significant. According to 'Sleep and performance--recent trends' by Himashree G, Banerjee PK, and Selvamurthy W, "The detrimental effects of sleep deprivation on psychological performance are indicated as increased lapsing, cognitive slowing, memory impairment, decrease in vigilance and sustained attention and shift in optimum response capability. Its effects on physical performance are manifested as decline in ability to perform maximal exercise, self-selected walking pace and increase in perceived exertion."

And this is where I come in. Functional exercises are not so functional when you're not functioning. I know, I've seen it, I've coached you through it and I've cried in the file room after you leave. Says, Robb Wolf fellow coach, author, gym owner and brilliant sciency kind of guy in the recent issue of Performance Menu, "Well, clinically we have observed a handful of clients who have been stalled with fat loss efforts. Zone diet, check. CrossFit champs, check. Fish-oil, check. Fat Loss: no-bueno. Thorough questioning uncovers an average nightly sleep allotment of 5-6 hours. Approximately 50-60% of the minimum 9.5 hrs of darkness 'Lights Out' recommends for most of the year. Fixing this problem (ya know, sleeping) can induce a 5% shift in scale weight in only a day or two (water loss due to decreased insulin and cortisol levels) and an immediate reduction in umbilical adiposity (belly fat = insulin resistance)."

And one last pointer, Dr. Czeisler suggests resetting your circadian rhythm if you need to operate on little sleep, "Photon for photon, looking up at the blue sky, for example, is more effective in both resetting our biological clock and enhancing our alertness than looking down at the green grass." Oh good, that should help us here.

Notes:1. The Harvard Business Online article costs money to download. Go figure. The interview quoted above was free but appeared by the same name.

2. The statistics regarding hospital mishaps came from NPR and aired this morning at a time when you should have been sleeping.

3. I did not read Addict Biol. 2002 Jul;7(3):285-90. “Does Paradoxical Sleep Deprivation And Cocaine Induce Penile Erection And Ejaculation In Old Rats?” in writing this post though apparently Robb Wolf did.

Monday, December 11, 2006

It's a season of resurrection not the least of which that of Rocky Balboa. Besides a thorough stroking of the amygdala, the movie is always a homage to simple, functional training and it's the only time I like comparing myself to Burgess Meredith.

In the film, whether Rocky has access to world class facilities or hefty logs carried through several feet of snow, he always opts for simple training that gets the job done. He works the same movements over and over again with varied loads and varied volume. It appears as if his training is a product of his coach's stubborn superstition and mythology coupled with the fighter's, well, cerebral limitations. Did I mention he wins?

Brazilian Jiu Jitsu professore Marcelo Alonso teaches well-worn movements in a wise study of 'what works.' In the Gracie camp, the focus is very much on the minutiae of the movements and it's a painstaking process in which we're often reminded that it takes 10,000 repetitions before a submission is done correctly. When I asked Cindy Hale, a local brown belt and amazing athlete under Gracie Baha what contributed to her rapid rise in the sport, she said, "I rolled. A LOT." Training the movements over and over again against a variety of opponents taught her to execute submissions smoothly against a variety of opponents. Simple. Without the will or the time to invest in repetitious movement studies, I heard a fighter exclaim in exasperation, "the only thing wrong with Brazilian Jiu Jitsu is the Brazilians."

Intuitive trainers who are passionate about performance don't let the science narrow their view or get tricked into thinking they have the mysteries of the body solved. It's training movement not muscle and letting the science sort itself out. But when there's new and sexy equipment out there and clients demand a technical explanation for everything we do, it's hard not to surrender to a place in which anatomy charts have our backs.

It does not take into account the contributions to movement by distant muscles which do not cross the joints involved in the action.

A given external movement pattern is not necessarily produced by the identical muscle actions every time that the movement takes place (this issue was also discussed by Dr Bernstein and in a recent copy of the Scientific American)

Recent research has shown that biological systems like the body do not necessarily rely on highly predictable, determinate, linear events in which one action always results in a specific result or in a result whose magnitude depends directly on the original stimulus. Thus, the body often tends to invoke processes that scientifically are known as nonlinear, indeterminate, random, chaotic or ‘fuzzy’. So, a small change in one muscle can produce either a small change, no change at all or even a large or damaging change in the external movement. Some workers who believe that injuries are caused by measurable ‘muscle imbalances’ invariably neglect to mention the important fact that apparently insignificant or indiscernible changes in muscle activation or lack thereof can serve as an even more relevant factor in the injury (and recovery) process. This means that all of their complicated muscle kinesiology descriptions and tests may be entirely irrelevant. The tricky part is that we currently have no way of determining exactly what the cause of anything but the most traumatic contact or impact injuries is. Much the same is true about chronic pain. In plain words, anyone who claims otherwise, is not telling you the whole truth.

And, in his conclusion:

"Because of this multiplicity of actions associated with multiarticular complex movement, Zajac and Gordon stress a point made by Basmajian (1978), namely that it may be more useful to examine muscle action in terms of synergism rather than agonism and antagonism.This is especially important, since a generalised approach to understanding human movement on the basis of breaking down all movement into a series of single joint actions fails to take into account that muscle action is task dependent."Now if Burgess Meredith assigned a bunch of isolation exercises to address specific imbalances to facilitate greater range of motion at the shoulder and if Rocky spent his last two weeks doing 'wall angels' it may have been a whole different movie. What's fun is when organizations that tout a higher understanding of this business called training manage to prove how ineffective sexy new equipment is in contrast to simply training movement.

Bursting Balance Bubbles

An article appears in The Journal of Strength and Conditioning Research, Volume 20, Number 4, November 2006 published by NSCA entitled 'Isometric Squat Force Output and Muscle Activity in Stable and Unstable Conditions.' In the article, of which I'll spare you a lot of the blah-blah anatomically-referenced noise, the conclusion when testing a standard squat against a squat executed on those blow-up balance disks, was as follows:

"The primary finding in this investigation is that isometric squatting in an unstable condition significantly reduces peak force, rate of force development and agonist muscle activity with no change in antagonist or synergist muscle activity. In terms of providing a stimulus for strength gain no discernable benefit of performing a resistance exercise in an unstable condition was observed in the current study." Yep, the darn things are useless. What is useful, however, is squatting - the plain, old-fashioned kind.

Mark Rippetoe, author of 'Starting Strength' http://www.startingstrength.com/ has 25 years experience in the fitness industry, 10 years personal experience as a competitive powerlifter and a sound contempt for organized science. His coaching cues are sparse but effective and he can sum up his feedback with a loud proclamation. That's "bull%^&*!" he'd say in that southern kind of way and with a special emphasis on the drawled 'bull'. I only got the benefit of his coaching for an afternoon but it was clear that he'd filtered through all the unnecessary to create a simple 'what works' for squatting. In the spirit of sound, functional training, and since it's Monday and CrossFit Eastside will have us all squatting 5x5, I offer the following:

Focus on form. If it deteriorates to the point that you're tipping forward on your toes or bending excessively at the waist, limit your rounds

Even better, if you don't want to wait until we meet again, drop by CrossFit Eastside www.crossfiteastside.com tonight at 6p. Michael and Carrie can give you additional expert coaching and help you determine proper loading. I'll be there and I'll happily introduce you around.

Sunday, December 10, 2006

". . . . but did the cows look happy?" I asked the Whole Foods butcher after plying him with far more relevant questions concerning the meat displayed. Considering the somewhat cryptic labeling and my complete distrust of the USDA, it's not surprising I'd prefer to go and shake a few hooves and interview my meal face to snout. If you're going to have a trainer and resources that support your healthy lifestyle, your butcher is as much a part of your training team and has as much to do with your athletic performance as I do.

How well we're fed depends on how well our food is fed whether it's nutrient dense soil for our produce or the proper diet for our livestock. We've done some horrendous thinks to our food supply in the name of mass production - none of it good. As a result, our food has become a great jaw exercise with limited value beyond the caloric expenditure of chewing and swallowing.

Many of you heard the prolonged hunter-gatherer stories including the pursuit of pastured chickens at the farmer's markets and the mucking about in the science of cow's dietary preferences. It included many hours of study and many experiments including my on-going effort to eat food produced within 100ish miles of my decidedly urban homestead. Here's what I found:

There are MANY Farmer's markets and they're a far more reliable resource for 100% grass fed meat. Any steer that's grain-finished will not have the same health benefits. Beware of farms that feed their cows waste such as leftover potatoes. I ran across one of those recently. You'll find suppliers in your neighborhood by first finding your Farmer's Market: www.wafarmersmarkets.com/market_dir.html.

I often shop at the U-District Market on Saturday, but if I'm busy I'll swing by Ballard on Sunday. You can find Samish Bay at both markets http://www.samishbaycheese.com/. The beef tastes spectacular but they feed their pastured eggs whey waste from the cheese production. I'm not so sure if that's healthy (back to the research).

I just ran across Skagit River Ranch. I haven't tasted the beef yet but I'm impressed so far. They have beef, pastured chickens, eggs and pork, and though they're wrapping it up at Ballard this week, they have a store and take bulk orders http://www.skagitriverranch.com/.

For online shoppers, I heard about this source on NPR http://www.tallgrassbeef.com/ and I remember hearing good things about them on the CrossFit message board awhile back. You won't get a chance to shake the farmer's hand but you'll save dollars per pound on the product.

Besides lugging the 20 pounds of Fed-exed meat into the kitchen, you'll need a farm inspired workout to honor your efforts. Here goes, and yes, of course it includes a farmer's walk:

Friday, December 8, 2006

I went to see my friend Taha, an aerialist and an all-around entrepreneur of athleticism, perform in a Holiday show. You just never know what the man will do next. I was awed. I may wear the rope-burn scar on my left ankle as some sort of climbing merit badge but my skills are rudimentary. I have the raw run-for-you-life skill in rope climbing but there's nothing pretty about my effort. For those of you ready to develop outstanding climbing skills to escape the mundane and run off to join the circus, I offer the School of Acrobatics and New Circus Arts http://www.sancaseattle.org/. The rest of you can just do the following:

The Challenge

For my advanced clients:30 Second L-holds on Paralellettes or Traveling Ls for 25 feetSee-saw pull-ups (PRO loves when I shred their towels) / Max SetHandstand Push-ups / Max Set(repeat See-Saws and HSPUs for three rounds)30 Second L-holds

For those of you who just exclaimed "are you freakin' kidding!"15 Jump to Support and Hold, bring your knees to your chestWaiter's walk with whatever weight you can muster - 50 Feet or a gym length and backhttp://www.crossfit.com/mt-archive2/waiter_walk.html3 Rounds

Many of you are familiar with these exercises, but if you're not or you need a refresher, please call me and I'll talk you through it.

Improvisation. If you can shake off the carb coma and break free of family long enough to get a work-out in, you're going to have to be savvy. I once had to manage a workout on my 30th Birthday in Prague where the 'gym' consisted of a rusty exercise cycle and a barometric chamber (?!). Oh, and no shoes were allowed for some reason. I also managed to perplex and alarm my 16 year old nephew when I did a walking lunge workout that grossly misjudged 50 meters and left me sore for days. And since the most many of you will be able to scare up in terms of space and equipment is a seldom used Treadmill in the corner of somebody's bedroom, I offer the following workouts in the hopes that they amuse nephews and nieces and keep you from feeling like a holiday equipment hamster running on your wheel.

Thursday, December 7, 2006

There are several reasons I was thinking about Turkish Get-Ups this morning. Maybe it was because I was concerned that my clients, under whatever duress this holiday season, should have the capacity to peel themselves off the floor (especially with impaired balance) or maybe it was that getting my own butt out from under the covers this morning at 4:30a felt a little more like a workout than a spry start to my day. Really, though, I was killing time during a cancellation reading Coach Dan John's 'Get Up!' newsletter which is devoted to throwing and lifting. It's that simple: It planted a seed. Regardless, it seemed fitting that my first post and my first challenge to you is an exercise that barks a command and inspires rapid compliance.

Your Challenge in the next three days

1 Rep Max Turkish Get-up (per side)

or, for those of you working at home, grab a lighter dumbbell and do as many Turkish Get-ups as you can complete in 20 minutes (alternating sides)

Search This Blog

About Me

I'm an NSCA-PT and CrossFit
certified personal trainer with nine years experience. I hold a purple belt in Brazilian Jiu Jitsu under Marcelo Alonso and Ben Blackstone and I am a Karnataka State Gold Medalist in Weightlifting.